Facet Joint Injection

What is a Facet Joint Injection?

A Facet Joint Injection is an injection of long lasting steroid into the facet joint. Facet joints are flat surfaces that touch where the vertebrae fit together. These joints are used in twisting, turning, and bending.

What is the purpose of the injection?

The steroid injected reduces the inflammation and/or swelling of the joint. The injection may not stop all pain but it may reduce inflammation and swelling. By decreasing pain, you will be able to actively participate in physical therapy as prescribed which is essential for optimal benefit.

What is injected? 

The injection consists of a mixture of a local anesthetic and steroid.

Will the injection hurt? 

The procedure is with x-ray guidance and involves inserting a needle through skin and deeper tissues. There is some discomfort involved. However, the skin and deeper tissues are numbed with a local anesthetic. Most of the patients also receive intravenous sedation which makes the procedure easy to tolerate.

Will I need more than one? 

Pain relief should last for weeks to months. If the pain returns, you may need a repeat injection.

What are the risks and side effects? 

With any procedure there are risks, side effects, and possibility of complications.  The most common side effect is pain, which is temporary. Other risks include infection, bleeding, prolonged pain,  nerve damage (very rare).

What should I expect after the injection? 

After the injection, you may feel that your mobility has improved which is a result of the local anesthetic. After the anesthetic wears off, you may have an increase in pain for the next 2-5 days then you should begin to see an improvement. This pain is due to the process of the needle insertion as well as the initial irritation from the steroid itself.  Use of ice is encouraged.

What should I do to prepare for the procedure?

To prepare for the procedure, do the following:
  1. Bring a list of your current medications, allergies, and surgeries with dates if known.
  2. If you are on any type of blood thinning medications  i.e. Coumadin, Heparin, Ticlid, Pletal, Plavix, Lovenox, Trental Aggrenox, Agrylin, please notify your physician at least 2 weeks prior to your appointment.
  3. Notify the Pain Management Center if you are pregnant or have an infection.
  4. You must have a driver with you.
  5. You may take routine medications including pain medicine. Please do not take blood thinning medications.
  6. You must not eat or drink 6 hours prior to the procedure.
  7. Please wear loose fitting clothing (elastic waist is advisable).

What should I expect the day of the procedure?

  1. Your medical history will be reviewed.
  2. You will be monitored during and for a minimum of 30 minutes after the procedure.
  3. An IV will be started.
  4. You will not be able to return to work that day. You are advised to go home and rest until the following day.  It is advisable to have someone with you at home for the remainder of the day.
  5. After the procedure you may eat. Normal medications except for the blood thinners may also be resumed. You will be advised when to restart blood thinners.